Can a Smoker Still Get All-on-4 Dental Implants?

I haven’t been happy with my dentures for as long as I can remember, and my dentist just said I’m a candidate for the All-on-4 procedure. During the consult, he asked me if I was a smoker, and I sheepishly told him “no,” because I didn’t want to be disqualified from having it done. Truth be told, I’ve been smoking about a pack a day for decades. My teeth have been a huge source of stress for me, and I think that being able to eat and talk right again will make it easier for me to quit. Is it safe to go forward with All-on-4 now and quit smoking when I’m less stressed afterwards?


June in Indiana

Dear June,

All-on-4 is an excellent option to replace an entire arch of missing teeth, but it’s not the best solution for everyone. The success of the dental implants relies heavily on your jawbone accepting the implants, and healing well. When this happens, your bone will integrate with the implant, enabling it to perform just like the root of your tooth did. It will be strong, sturdy, and healthy.

When you smoke, it affects your entire body, including your oral health. It may take longer for the healing phase to complete, or your body might not accept the implant at all. People who smoke are also more prone to getting infections when a dental implant is placed, which can cause it to fail. One of the latest studies tracked 165 people for five years. Smokers who received dental implants had a failure rate of nearly 16%, but non-smokers came in closer to 1%.

There’s no way to tell in advance if your All-on-4 procedure will fail because you smoke. Flipping the statistics around, there’s an 84% chance yours will be successful, but undoubtedly you’d like to be closer to 99%, like the rest of the population. In order to do so, you’ll need to quit smoking before the procedure, and allow your body some time to heal. Some dentists won’t do the All-on-4 procedure for a patient who smokes because of the added risk, but it’s important to be upfront with your doctor about your habits. He may be able to provide you with resources to help you quit, and he’s also likely to monitor your progress more closely, since you’ll be in a high-risk group.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Horrified by dental emergency for a young child.

I came across a highly disturbing article about a young girl that needed to have all 16 of her teeth pulled. This wasn’t in the United States, but I was wondering what the protocol would be for an emergency dentist visit here in the US? Does this happen more than we hear about? I just can’t imagine the fear this little girl must have endured. And shouldn’t there have been some kind of signals before it was too late to have taken such drastic measures?

– Carol in Texas


You are likely referring to the following article that seems to have drawn a lot of interest from media sources. It was published in The Daily Mail. Assuming this is the article you are referring to, it involved a four-year-old little girl. She was in terrible pain and started becoming increasingly withdrawn and reserved. The pain got to be too much and her mother finally took her to the dentist. The main factor that became apparent was that she was aloud to have a bottle anytime of day. Imagine a child being bottle-fed, 24 hours, around the clock. The decay was so severe the tooth extractions was the only logical solution.

We don’t know all the facts, only what the article disclosed. But dentists agree that bottles should not be given before bed. This practice is commonly referred to as “baby bottle rot.” Many times parents will give a late night bottle to soothe a child or put them to sleep. But if they fall asleep while drinking, the liquid stays in the teeth for hours and increases the likelihood of decay in young children and babies.

Pediatric dentists in the United States advise that parents take children to the dentist, as soon as the teeth erupt. Early monitoring and regular checkups should prevent any dental emergencies or extreme situations that could be detrimental to children’s oral health. This was indeed an extreme case that you are referencing. The parents need to take initiative to pave the way for their children’s health teeth and gums.

Thank you for your question. Prevention is always key when avoiding dental emergencies.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Can I Be Left Alone After Sedation Dentistry?

I have serious dental anxiety and I’m dreading having to go in for my next couple rounds of dental work. My doctor says I’m a candidate for sedation dentistry, but he also told me that I have to have someone drive me to the appointment, and I can’t be left alone afterwards. I’m a single mom, and I don’t have any backup or help. I don’t even know if I can get a ride to the office, let alone find someone to stay with me at home afterwards. How soon after sedation dentistry can I go back to my normal routine? Will they even know if I drive or ride the bus home afterwards?


Laura in Minnesota

Dear Laura,

Yes, they will know. Offices that perform sedation dentistry have a protocol in place, and they’ll check in with you before you go back for treatment to verify you have someone with you. With that said, whether or not they know isn’t the primary concern. The medication that’s usually given in sedation dentistry is long-lasting, and may affect you for the rest of the day.

The medications given are very powerful. Many offices keep a wheel chair available to help patients out to their vehicles after treatment. Even though you won’t be asleep, you’ll be drowsy and clumsy for sure. This is probably the biggest risk for most patients after treatment. They overestimate their abilities, and that makes it easy to fall or trip. So, even if you feel like going home and cooking dinner and getting back to normal life, it’s far better to kick your feet up. There’s also a very small risk of having an adverse reaction to the medication after you leave the office, so it’s really a good idea to have a responsible adult with you that day.

One of the additional benefits of sedation dentistry is that you can often have more treatment done at once, so there’s a chance you’ll only need to make arrangements for help one time. If it truly isn’t a possibility for you, it’s worth looking into having the treatment done with just nitrous oxide. Often called “laughing gas,” it’s been used in dental treatment for generations, and the effects wear off right away. Your dentist or primary care physician may also be able to prescribe a low dose of an anxiety medication that will help take the edge off, without all-day side effects.

Let your dentist know what your concerns are, and see if you’re a candidate for an alternate option, but please don’t go against the instructions and spend the afternoon alone.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Looking for affordable dental care. Please help!

I don’t have dental insurance. Therefore, I avoid going because it is so expensive. What is the best way to find affordable dental care? I know beauty schools offer discounted hair cuts and services. Are dental schools similar? Will it be lower cost to have dental work done by a student? Please help!

-Sherry in Iowa


That is a great question and great idea. The answer is yes, dental schools will offer more affordable dental care if you are open to having the work done by students. Keep in mind that since they are students, the appointment may take longer. They are still learning which means they’re slow. Their work is overseen by an instructor and you will have to wait to have the work checked. This is a good option if you are looking for low-cost dentistry because it is nearly half the price of what you would pay in a private practice.

You also need to keep in mind that the standard of care may not be what you expect from a dentist. It would be sub-standard, just not the caliber you may be accustomed to.

Use google to fine an affordable dentist near you. Most dental schools will have an online application or appointment form for your to fill out. For functional issues, this could be a good solution. But if you are dealing with aesthetic concerns, you don’t want to cut corners. Cosmetic dentistry is an art and it wouldn’t be advised to get this type of treatment done by students.

Thank you for your question.

This post is sponsored by Cleveland dentist Hylan Dental Care.


Do I need a holistic dentist if I’m pregnant?

I am super paranoid about everything I’m putting in my body now that I’m finally pregnant after trying for two years. I’m doing everything I can to be proactive about any medications, etc. Do I need to find a holistic dentist during pregnancy? When I was at my routine appointment last week, they wanted to give me x-rays even after I told them I’m pregnant. That has me really questioning if I want to continue care at this dentist. I was literally shocked when they tried to expose the baby to radiation. I got out of there with a simple cleaning, but they are trying to get me in again soon to treat a couple teeth. Am I over-reacting? I will do everything within my power to keep this little one safe.

-Laurie in South Carolina


It sounds like a congratulations is in order! Well, it is of course your choice and completely understandable that you would be considering a holistic dentist during your pregnancy. That said, your dentist didn’t necessarily do anything wrong. Dental x-rays put out a very low form of radiation and are typically not an issue during pregnancy. Also, most x-rays are digital now which have even less radiation. You should have definitely been offered a protective apron to wear across your mid-section as an added safety precaution, as well. Again, if you are overly concerned, discuss it with your OB.

As for having any further treatment done, you definitely want to have the dentist be in contact with your OB to ensure you aren’t at a high risk for anything. Oral health should be maintained during pregnancy to prevent bacteria  and any risk of periodontal disease. So as a general rule of thumb, you definitely want to keep up with your regular dental cleanings and exams during pregnancy.

If the treatment that is required is invasive, your OB may advise waiting until after the first trimester to schedule it. This is because so much of the crucial fetus development occurs in those first few months. Whatever you decide about continuing care with your current dentist or checking out a holistic dentist, it would be wise to bring your OB into the loop. Thank you for your question. There is nothing wrong with taking those extra precautions in keeping that unborn bundle of joy safe.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Can I get dental implants if I have diabetes?

Diabetes rules my life. Well, now I have a tooth that needs to be replaced. I was wondering if I will be able to get a dental implant? Is it a contraindication for someone with Type 1 diabetes?

-Michelle in Maryland


Good news! Type 1 diabetes is not a contraindication for dental implants. That said, you need to make sure your physician and dentist are in close communication. There are high risk factors with dental implants for individuals with diabetes.

The diagnostic work is key for you. All of the risk factors need to be evaluated and your dentist and physician need to coordinate through the surgical phase and all the way through to the restoration phase of the dental implant. Make sure you find an implant dentist that understands diabetes and all that is involved with your condition. If you haven’t found one yet, you can go to the International Congress of Oral Implantologists or the American Board of Oral Implantology. If you find a dentist in your area with credentials like fellow or diplomat with either of these organizations, there is a good chance they will be a good fit for you.

Dental implants are a highly advanced procedure, between the oral surgery component and the restorative process. If the implant dentist you select uses an outside oral surgeon, you must also be in communication directly with them regarding your condition. You don’t want to risk complications to your health or issues that the dental implant would fail. Best of luck to you and thank you for your question.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Looking for options for a dead tooth.

I have a dead tooth. It’s ugly and black and pretty much makes me feel like a hillbilly. I need to have it fixed. I can’t ever remember hurting or damaging it. The tooth has been like this for awhile. My dentist says it had to be due to a trauma of some sort. I don’t remember that instant, but it is quite discolored. I have grown up cracking jokes about my appearance. I acted like it was a choice. In reality, my parents couldn’t afford to have it fixed. Well, now that I’m graduating college and heading into the workforce, I want to be done making jokes. The dentist says it needs to be extracted and recommended a dental implant. Well, when I saw the price tag, I now understand why my parents couldn’t afford to fix it. Are there any other options to replace this dead tooth, aside from a dental implant?

-Karrie in Nevada


Well, it sounds like you have been making lemonade out of lemons for many years. Kudos to you on handling it through those tough teenage years. But now it is completely understandable why as an adult, you are ready to fix the aesthetics of your smile.

Your dentist is correct that you likely damaged the tooth. It could have happened when you were a kid and probably didn’t realize the extent of the problem. It also may have happened quite gradually after the incident. But that’s neither here nor there. From what you have described it sounds like the blood flow has stopped flowing to the tooth. The tissue is dead and there was probably an infection at one point. A root canal would have remedied the problem. But since it wasn’t done, the root may have been absorbed into your body over time. But since there is no longer any blood flow, it is really only a matter of time before you have problems and it may fall out. So it would be wise to have the tooth extracted.

A dental implant is a permanent solution to your missing tooth. It is the best option and looks, feels, and functions just like a normal tooth. But there’s no denying it, an implant is expensive. It is not your only option. A  dental bridge is a more affordable alternative. What happens in this regard is a porcelain crown is placed on each of the surrounding teeth and the false tooth is attached to those two surrounding crowns to fill the empty space. The big problem with this option, especially on a front tooth, is that if those other two teeth that require crowns are healthy, then it really doesn’t make sense to prepare them for crowns. This is because it is quite an invasive treatment that removes a large portion of those otherwise healthy teeth.

A partial denture or dental flipper is an economical option. This is a removable appliance that you wear that has a false tooth attached to it. This may end up being a shorter term solution until you can afford to replace the tooth with a dental implant. Hopefully this information was helpful.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Is it safe to remove amalgam fillings?

I have several very old silver fillings from when I was a kid. I honestly can’t even believe that they are still in tact. My old dentist told me that they were fine as long as they weren’t bothering me and it was perfectly fine to keep them. But I want to get them replaced with white fillings. I heard the mercury can leak in the removal process. Is that true? Is it safe to get the old ones removed or more of a risk to my health?

-Pam in Indiana


Many people are concerned about the possible negative health risks that exist from having mercury in their mouth. Some feel strongly that amalgam (silver) fillings release some of the mercury gas as they get older and become corroded. Although, the possibility exists, it is important to mention that the ADA still deems them to be completely safe.

It’s true that the amalgam removal process is dangerous if it is not done properly. So you want to seek out a mercury-free dentist that offers sanitary amalgam removal services. You may also find a qualified individual that offers these services by searching for a holistic dentist or natural dentist, as well. A dentist like this will be specifically trained to safely remove old amalgam fillings. This will keep you safe by minimizing your exposure to the mercury-containing substance. There is special equipment and techniques that a holistic dentist uses, including an alternate breathing source and total isolation of the tooth that is being treated. These safety measures will ensure that you do not breathe in or swallow any of the harmful materials.

Then, white composite fillings are used to replace the old amalgam fillings. These new fillings offer many benefits. They strengthen the tooth, do not contain mercury, have less post-operative sensitivity, and look nicer too. They require an advanced training and understanding of bonding techniques to properly place them.

On the other hand, if your old fillings haven’t chipped or cracked, it is not necessary that they be removed. They may function just fine for years to come. If you are concerned, it would be wise to discuss your options with your current dentist. Thank you for your question. This subject continues to be highly controversial in dentistry today, especially as there are more holistic dentistry options.

This post is sponsored by Cleveland dentist Hylan Dental Care.